Neural tension in Physiotherapy

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What is neural tension?

Neural tension can occur when nerves are not sliding and gliding through tissues as they usually would. The nerves that supply the sensation and movements to your arms and legs are called “peripheral nerves.” When neural tension occurs in peripheral nerves, it can cause areas of referred symptoms into parts of your limbs.

Symptoms of neural tension:

Neural tension symptoms may include the following:

Referred pain. Often this occurs in the parts of your limbs that are the furthest away from your body. For example: your fingers, toes, feet, hands or calves.
Tingling.
Pins and needles.
Burning sensations.
Altered movement.
Reduced sensation.

What can cause neural tension?

Many different factors may contribute to the onset of neural tension. Some of these contributing factors include:

Sustained periods of inactivity.
Repetitive movements (whether it’s exercise-related, work-related or simply something you do frequently in your daily routine).
Tension in the surrounding muscles or fascia (connective tissue).
Narrowing of your joints due to changes in bone structure over time.
Disc bulges that narrow the spinal canal (where the nerve roots exit from the spinal cord).

This chart shows some of the peripheral nerves that can be affected and the potential areas of altered sensation:

Nerves in the upper limb:	Potential areas of reduced sensation:
Ulnar	Palmar surface of medial 1 and a ½ fingers Dorsal surface of medial 1 and a ½ fingers
Radial	Back of forearm Back of index finger, thumb, middle finger and ½ pinky finger
Median	Skin over the thumb, palm, 2nd/3rd/lateral ½ of the 4th finger
Musculocutaneous	Skin to lateral forearm

Nerves in the lower limb:	Potential areas of reduced sensation:
Femoral	Anterior / medial thigh Medial side of leg/foot potentially tracking up to the ball of the big toe
Sciatic	Skin of the lateral leg and heel Dorsal and plantar surface of the foot
Obturator	Hip and knee joints Skin over medial adductor muscles

What can PMPP do for your neural tension?

Our Physiotherapists will undertake a thorough physical assessment with you. In addition to determining any potential contributing factors, we will look at your associated symptoms. Physical assessment may include the following:

Postural assessment.
Assessing range of movement.
Neural tension tests.
Spinal mobilisation.
Strength testing.
Muscle length testing.

Depending on the physical findings, your treatment may include the following modalities:

Massage.
Joint mobilisation.
Dry needling.
Taping.
Neural sliding/gliding.
Clinical exercise for mobility/strength.
Postural education/advice

What can you do to prevent neural tension?

Neural tension in the upper or lower limbs can be prevented by implementing some of the following strategies:

Regular stretching of tight muscles. Such tight muscles may include the wrist flexors/extensors, neck muscles, pectorals, calves, hamstrings, glutes or quads.
Regularly foam rolling along the thoracic spine, ITB, quads, calves or hamstrings.
Ensuring an ergonomic desk set up.
Changing posture every 30-40mins to avoid prolonged sitting or standing.
Being conscious of spinal and scapular posture, especially when using arms for functional tasks.
Using a spiky ball for the muscles of the rotator cuff, in between the shoulder blades and spine and the gluteal muscles.
Physiotherapy treatment every 6-8 weeks to prevent structures around the nerves tightening up. This is especially relevant if you know that you’re prone to tightness/stiffness due to daily activities.

~Leah Christoforou
Physiotherapist

Enjoy some stretching-based home workouts via our PMPP YouTube channel: https://www.youtube.com/channel/UClngrhTqRpn87x15J8FeUPg

The Salt Lab magnesium range is wonderful for easing muscle tightness and can be purchased in the clinic. Learn more here: https://www.saltlaboratory.com